摘要
目的调查“全面三孩”政策前后九江地区计划生育技术服务项目结构变化与女性生育意愿变化。方法采用计划生育服务情况调查报表统计九江地区(含4个区、7个县、3个县级市)“全面三孩”政策前后(2020至2022年)计划生育技术服务各项项目例数及占比,了解其变化情况。统计2020至2022年“全面三孩”政策前后九江地区女性生育意愿变化情况,比较有无生育意愿女性“全面三孩”政策前后例数及占比变化,并采用Logistic回归分析“全面三孩”政策下影响2022年女性生育意愿的影响因素。结果2020至2022年九江地区计划生育技术服务总体呈下降趋势,平均增长速度为-13.84%,其中宫内节育器放置手术、宫内节育器取出手术、负压吸引术、钳刮术、药物流产和输卵管绝育术数量总体均呈下降趋势,平均增长速度分别为-11.82%、-2.92%、-16.28%、-23.81%、-15.60%、-28.78%;皮下埋置剂放置、取出手术、输卵管吻合术数量总体呈上升趋势,平均增长速度分别为73.20%、17.51%、83.23%;2021至2022年宫内节育器放置手术数量突减,降幅达30.07%;而输卵管吻合术数量突增,增幅高达261.54%。2020至2022年九江地区女性有、无生育意愿人数均逐渐减少,其中无意愿生育人数减少更为明显。2021至2022年无意愿生育人数突减,降幅高达28.98%。单因素分析结果显示,有生育意愿和无生育意愿女性年龄、民族、学历水平比较差异无统计学意义;有生育意愿和无生育意愿女性户口所在地、婚姻状况、家庭月收入、理想孩子个数和现有孩子性别比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,家庭月收入≤10000元和现有孩子性别为1男1女为“全面三孩”政策下2022年九江地区女性生育意愿的独立危险因素(P<0.05)。结论“全面三孩”政策出台后九江地区计划生育技术服务项目使用率呈大幅下降趋势,尤其是输卵管绝育术、人工流产手术和宫内节育器放置术数量下降更为显著。“全面三孩”政策出台后女性生育意愿仍较低,家庭月收入≤10000元和现有孩子性别为1男1女是影响2022年九江地区女性三孩生育意愿的独立危险因素,相关部门应合理引导、出台针对性措施,以推动“全面三孩”政策的落实,优化我国人口结构。
Objective To investigate structural changes of family planning technology service items and changes of female fertility intention in Jiujiang before and after"comprehensive three-child"policy.Methods The number and proportions of family planning technology service items in Jiujiang(including 4 districts,7 counties and 3 county-level cities)were statistically analyzed by questionnaires of family planning service before and after"comprehensive three-child"policy(2020 to 2022)to understand the changes.The changes of female fertility intention in Jiujiang before and after"comprehensive three-child"policy from 2020 to 2022 were statistically analyzed,and changes in number of cases and proportion between females with fertility intention and those without fertility intention before and after"comprehensive three-child"policy were compared.The independent influencing factors of female fertility intention in 2022 under"comprehensive three-child"policy were analyzed by multivariate Logistic regression analysis.Results From 2020 to 2022,overall trend of family planning technology services in Jiujiang was decreased,with an average growth rate of-13.84%.The number of intrauterine device placement,intrauterine device removal,vacuum aspiration,forceps curettage,drug abortion and tubal sterilization were gradually decreased,with average growth rates of-11.82%,-2.92%,-16.28%,-23.81%,-15.60%and-28.78%,respectively.The number of subcutaneous implants placement,implants removal and tubal anastomosis were gradually increased,with average growth rates of 73.20%,17.51%and 83.23%,respectively.From 2021 to 2022,number of IUD placement was decreased by 30.07%,while number of tubal anastomosis was increased by 261.54%.From 2020 to 2022,number of females with and without fertility intention in Jiujiang was gradually decreased,and the decrease was more obvious in those without fertility intention.From 2021 to 2022,number of females without fertility intention was decreased by 28.98%.The results of univariate analysis showed that there was no significant difference in age,nationality or education level between females with fertility intention and those without fertility intention,but there were significant differences in registered residence,marital status,monthly family income,number of ideal children and gender of existing children(P<0.05).The results of Logistic regression analysis showed that monthly family income≤10000 yuan and the gender of the existing child was 1 male and 1 female were independent risk factors of female fertility intention in Jiujiang in 2022 under"comprehensive three-child"policy(P<0.05).Conclusions After the introduction of"comprehensive three-child"policy,utilization rates of family planning technology service items are significant decreased in Jiujiang,especially the number of tubal sterilization,artificial abortion and intrauterine device placement.After the introduction of comprehensive three-child policy,female fertility intention is still low,monthly family income≤10000 yuan and the gender of the existing child was 1 male and 1 female are independent risk factors affecting fertility intention in Jiujiang in 2022.The relevant departments should give reasonable guidance and introduce targeted measures to implement"comprehensive three-child"policy and optimize national population structure.
作者
吴巍
陈金霞
杨腊枝
WU Wei;CHEN Jinxia;YANG Lazhi(Department of Obstetrics and Gynecology,Jiujiang Maternal and Child Health Hospital,Jiujiang,Jiangxi,332000,China)
出处
《当代医学》
2024年第33期40-44,共5页
Contemporary Medicine
基金
江西省卫生健康委科技计划项目(202311616)。
关键词
“全面三孩”
计划生育技术服务项目
生育意愿
影响因素
"Comprehensive three-child"
Family planning technology service item
Fertility intention
Influencing factor
